W. Boylston, Holden residents accused of bilking state Medicaid program

Wednesday

Feb 13, 2013 at 1:00 PMFeb 13, 2013 at 1:30 PM

THE BOSTON GLOBE

Eight people are facing charges that they defrauded the state's MassHealth program of approximately $260,000 by falsely billing for personal care attendant services that were not provided, the attorney general's office announced today.

In one case, the person who was supposed to be providing care was allegedly incarcerated at the time services were supposedly provided. In another instance, the personal care attendant was allegedly out of state, traveling extensively, and working another job. In a third instance, the program was charged for services for a person who was dead, the attorney general's office said.

The MassHealth program, the state's Medicaid program, allows people with chronic or long-term disabilities to live independently by providing them with money to hire personal care attendants to help patients with daily life.

“MassHealth is a critical program that provides health insurance for some of our most vulnerable residents,” Attorney General Martha Coakley said in a statement. “The brazenness of the fraud committed in these cases is particularly troubling. The defendants allegedly stole more than $260,000 from taxpayers, diverting resources from those who truly need it.”

Under the MassHealth PCA program, patients who are unable to manage hiring and firing of PCAs may pick a “surrogate” to act for them. Usually, that's a family member or guardian, the attorney general's office said.

The eight people facing charges include five former attendants and three surrogates. They were charged in several different schemes.

“These investigations act as a deterrent to criminals and help agencies and vendors better manage Medicaid programs so that benefits are available for those who need them most,” State Auditor Suzanne Bump said in the statement.

The attorney general's office said it had worked with the auditor's office and the inspector general's office of the US Department of Health and Human Service in the investigation.

Indictments were returned this week by Worcester, Hampden, and Hampshire county grand juries. A criminal complaint has also been in Boston Municipal Courot in West Roxbury.